title: Optimal level of continuous positive airway pressure: auto-adjusting titration versus titration with a predictive equation.
abstract: OBJECTIVE
  The aims of the present study were twofold. We sought to compare two methods of titrating the level of continuous positive airway pressure (CPAP) - auto-adjusting titration and titration using a predictive equation - with full-night manual titration used as the benchmark. We also investigated the reliability of the two methods in patients with obstructive sleep apnea syndrome (OSAS).
  
  
  METHODS
  Twenty consecutive adult patients with OSAS who had successful, full-night manual and auto-adjusting CPAP titration participated in this study. The titration pressure level was calculated with a previously developed predictive equation based on body mass index and apnea-hypopnea index.
  
  
  RESULTS
  The mean titration pressure levels obtained with the manual, auto-adjusting, and predictive equation methods were 9.0 +/- 3.6, 9.4 +/- 3.0, and 8.1 +/- 1.6 cm H2O,respectively. There was a significant difference in the concordance within the range of +/- 2 cm H2O (p = 0.019) between both the auto-adjusting titration and the titration using the predictive equation compared to the full-night manual titration. However, there was no significant difference in the concordance within the range of +/- 1 cm H2O (p > 0.999).
  
  
  CONCLUSIONS
  When compared to full-night manual titration as the standard method, auto-adjusting titration appears to be more reliable than using a predictive equation for determining the optimal CPAP level in patients with OSAS.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Ji Ho
authors.initials: JH
authors.lastname: Choi
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Jun
authors.forename: Jeong In
authors.initials: JI
authors.lastname: Oh
authors.forename: Jong Yoon
authors.initials: JY
authors.lastname: Jung
authors.forename: Gyu Ho
authors.initials: GH
authors.lastname: Hwang
authors.forename: Soon Young
authors.initials: SY
authors.lastname: Kwon
authors.forename: Heung Man
authors.initials: HM
authors.lastname: Lee
authors.forename: Tae Hoon
authors.initials: TH
authors.lastname: Kim
authors.forename: Sang Hag
authors.initials: SH
authors.lastname: Lee
authors.forename: Seung Hoon
authors.initials: SH
authors.lastname: Lee
mesh_terms: D000328:Adult; D015992:Body Mass Index; D045422:Continuous Positive Airway Pressure / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000628:therapy*